We know that often in neurodegenerative conditions, changes to the brain begin decades before symptoms appear. Many believe therefore that we stand a better chance of slowing or stopping the disease process, if we intervene with treatments at the earliest stages. But how do we detect these subtle biological changes, and identify those who are at most risk of developing disease?
Biomarkers have huge potential to transform our understanding of disease and the development of therapeutics. Short for ‘biological markers’, they are a measure – or a flag – of a biological state, helping us identify and monitor healthy biological processes or, crucially, harmful changes occurring in disease. Fluid biomarkers, such as molecules and proteins found in the blood or cerebrospinal fluid (CSF) which bathes the brain, are of high interest as they are already providing useful information about the state of the brain. Cutting-edge technology now allows for ultrasensitive detection of biomarkers even in very early stages before disease symptoms present.
How will biomarkers help find cures for dementia?
There are two main ways that biomarkers can assist the search for new dementia treatments:
Detection – When testing treatments for the early stages of a disease like Alzheimer’s, it is difficult to recruit similar clinical trial participants that reliably go on to develop the condition. Researchers currently rely on costly genetic testing and brain imaging, invasive procedures to obtain CSF or highly variable diagnosis from wide-ranging symptoms. The development of an accurate blood test for each neurodegenerative disease would be transformational for medicine, not only hugely improving screening for clinical trials but eventually providing a low-cost diagnosis solution for the whole population.
Monitoring – The majority of neurodegenerative disorders progress over many years with new symptoms presenting as further brain regions are damaged. It is likely that it will additionally take a long time to see the positive effects of treatment in clinical trials. New biomarkers will allow us to monitor early biological changes following intervention, helping researchers make crucial decision such as whether to persevere or halt treatment. These biomarkers are also important for tracking disease progress in research models during critical phases of discovery science.